Which sonographic appearance of the normal epididymis is the most common?

The normal epididymis typically appears as a homogeneous structure that is either isoechoic or slightly hypoechoic compared to the testis. The most accurate description is "homogeneous compared to the testis," meaning the texture is uniform. It is not anechoic, nor does it typically show irregular borders unless pathology is present.

According to Rumack’s Diagnostic Ultrasound:

"The normal epididymis appears homogeneous and is isoechoic or slightly hypoechoic relative to the testis." (Rumack CM et al., Diagnostic Ultrasound, 5th ed.)